1. Introduction To
Cyst Classification
&
Dr V.RAMKUPaMthoApRhysiology
CONSULTANT DENTAL
&FACIOMAXILLARYSURGEON
REG NO: 4118 TAMILNADU-INDIA(
ASIA)
2. Cyst
KRAMER-1974
Definition :
Cyst is defined as a pathological cavity having fluid, semi-fluid or
gaseous contents that are not created by the accumulation of pus;
frequently, but not always, is lined by an epithelium
3. Killey & Kay -1966
• Cyst is an abnormal cavity in hard and soft
tissues which contain fluid, semifluid, or
gas and is often encapsulated and lined by
epithelium.
4. CLASSIFICATION OF CYSTS
(W.H.O)
• A. EPITHELIAL
1. Odontogenic
a) Developmental:
i ) Primordial cyst (Keratocyst)
ii) Gingival cyst of infants
iii) Gingival cyst of adult
iv) Lateral periodontal cyst
v) Dentigerous cyst (Follicular)
vi) Eruption cyst
vii) Calcifying odontogenic cyst
5. b. Inflammatory:
i) Radicular cyst
ii) Residual cyst
iii) Inflammatory collateral cyst
iv) Paradental cyst
2. Non odontogenic Cysts:
i) Nasopalatine duct cyst (incisive canal)
ii) Median palatine, Median alveolar &
Median mandibular cyst
iii) Nasolabial cyst ( Nasoalveolar cyst)
iv) Globulomaxillary cyst
6. B. NON EPITHELIAL
CYSTS
1. Simple bone cyst
(Traumatic, Solitary,
hemorrhagic bone cyst)
2. Aneurysmal bone cyst
7. II) CYSTS ASSOCIATED
WITH
MAXILLARY ANTRUM • Benign mucosal cyst of maxillary antrum
• Surgical ciliated cyst of maxilla.
8. III) CYSTS OF THE SOFT TISSUES
OF THE MOUTH, FACE & NECK
1) Dermoid and epidermoid cysts
2) Branchial cyst (Lympho epithelial)
3) Thyroglossal duct cyst
4) Anterior median lingual cyst
5) Oral cyst with gastric and intestinal epithelium
6) Cystic hygroma
7) Cysts of the salivary glands
8) Parasitic cysts: Hydatid cyst: Cysticercus
Cellulosal
11. Initiation
• Inflammatory cysts – infection
• Other cysts –
-dental lamina
-enamel organ
-reduced enamel epithelium
-cell rests of malassez
12. ENLARGEMENT
1. ATTRACTION OF THE FLUID INTO THE CYST CAVITY
2. THE RETENTION OF THE FLUID WITH IN THE CYST
3. THE PRODUCTION OF RAISED INTERNAL HYDROSTSTIC
PRESSURE
4. THE RESORPTION OF THE SURROUNDING BONE WITH AN
INCREASE IN THE SIZE OF THE BONE CAVITY
13. HARRIS 1974-
THEORIES OF CYST
EXPANSION
1. MURAL GROWTH THEORY
2. HYDROSTATIC ENLARGEMENT
3. BONE RESORBING FACTOR
17. DIAGNOSTIC FEATURES
WATCH BEFORE THE CATCH
• CLINICAL FINDINGS
• Signs and symptoms of a jaw lesion depend
on the dimension of the lesion.
• Small cysts – Detected at an early stage as a
corollary to routine radiographic
examination.
• Large cysts – Usually in case of a typical
odontogenic cyst “expansion” of the labial or
buccal aspect of the alveolar bone occurs.
18. Cont……
• Odontogenic cyst in the ramus or third
molar region can cause Expansion of
the lingual aspect alone.
• Expansion of both the inner and outer
bony margins is indicative of a lesion,
other than a cyst.
19. EXPANSION
• Growing cyst causes a locally discernible
bulging of the External bony surface
• Increase in size – Subperiosteal bone
formation
• Early stage – Smooth, hard, painless
prominence
• later expands to make the outer cortex thin
with out micro fractures of the outer cortex
• “ PING PONG BALL” CONSISTENCY
20. ELASTIC
• The bone covering centre of the
convexity becomes thinned and can be
indented with pressure as the cyst
growth proceeds
• The term “ELASTIC” is used to
describe this consistency
• Micro Fracture Of The Outer Cortex
Seen
Egg shell crackling
21. INCIDENCE OF VARIOUS CYSTS IN
DIFFERENT PARTS OF THE DENTAL
ARCH
• Periodontal cyst – Anywhere in the dental
arch
• Dentigerous cyst – Associated with impacted
molars, displaced canines, premolars and third
molars
• Fissural cyst – Mostly Confined to the upper jaw
& in the region of anatomical bony fusion
22. Cont….
• Solitary bone cyst – Present only in the
mandible
• Odontogenic Keratocyst – Lower third
molar area and extending in to the ramus
AND mandibular canine regions
23. OTHER CLINICAL FINDINGS…
• Loosening of teeth
• Involvement of neurovascular bundle
• Presence of sinus tract
24. SYMPTOMS
Small cysts – Asymptomatic
Initial symptoms – Pain and swelling due to infection
Large cysts – Pathological fracture in the weaker part jaw
associated with pain and swelling.
Edentulous – Displacement of denture
Discoloration and loosening of tooth
26. RADIOGRAPHIC
INVESTIGATIONS
• Well defined round or oval area of radiolucency
circumscribed by a sharp radiopaque margin
• Radiographic variations possible depending on
the type of the cyst, its location and the degree
of bone destruction and expansion
• Certain odontogenic and normal anatomic
structures mimic radiolucencies suggestive of
cyst formation
35. ASPIRATION
• Aspiration is done with a wide bore needle
• Aspirated fluid – Straw colored fluid containing
glary cholesterol crystals, provisional diagnosis
would be a dental cyst
• Keratin flakes (White cheesy material )
• Aspiration of air – Penetration in to the antrum
• Failure to aspirate fluid or air – Solid lesion
